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Contact Information

INDIGO WELLNESS GROUP LLC
144 MORGAN ST STE 1
STAMFORD, CT06905-5433
 Phone: 203-658-7850
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Acupuncturist

171100000X
 

Clinical

1041C0700X 80 Licensed Clinical Social Worker
 

Dietitian, Registered

133V00000X 71 Registered Dietitian or Nutrition Professional
 

Multi-Specialty

261QM1300X 70 Clinic or Group Practice
 

Physical Therapy

261QP2000X
Indicates primary specialty

NPI Profile & details for INDIGO WELLNESS GROUP LLC · (Female)

NPI # 1033742481
Status Active
Credentials
Entity Individual
Enumeration date 02/13/2020
Last updated 12/15/2023 - About 2 years ago
Sole proprietor 1 Not specified
Identifiers
  • CT Medicaid 1942680111
  • NY Medicaid 1679808455
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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